A nurse is caring for a client with binge eating disorder. Which goal should the nurse establish first with the client?

Obtain satisfaction with appearance.

Achieve steady weight loss.

Institute an exercise plan.

Regulate food portions.

Answer and Explanation

The Correct Answer is D

Choice A reason: While obtaining satisfaction with appearance is an important long-term goal, it is not the first step in treatment. Addressing the behavior itself is crucial before tackling self-image issues.

Choice B reason: Achieving steady weight loss is a goal that will likely result from regulating food portions and other treatment interventions. It is not the initial focus when establishing treatment goals.

Choice C reason: Instituting an exercise plan is part of a comprehensive treatment plan but is secondary to establishing control over eating behaviors.

Choice D reason: Regulating food portions is essential for reducing the frequency and volume of binge eating episodes, which is the immediate concern in binge eating disorder management.

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Correct Answer is C

Explanation

The correct answer is: c. Inspiratory and expiratory bilateral crackles.

Choice A: Average urine output of 28 mL/hour

Reason: The normal urine output for an adult is typically 0.5 mL/kg/hr, which translates to about 30-50 mL/hr for most adults. An average urine output of 28 mL/hour is slightly below this range, indicating possible inadequate fluid resuscitation. However, it is not immediately life-threatening and does not warrant the most urgent intervention compared to other options.

Choice B: Vesicular bibasilar breath sounds

Reason: Vesicular breath sounds are normal lung sounds heard over most of the lung fields. They are soft and low-pitched, indicating that the airways are clear. Therefore, vesicular bibasilar breath sounds do not indicate any immediate respiratory distress or fluid overload and do not require urgent intervention.

Choice C: Inspiratory and expiratory bilateral crackles

Reason: Crackles, also known as rales, are abnormal lung sounds that indicate the presence of fluid in the alveoli. Bilateral crackles heard during both inspiration and expiration suggest significant pulmonary edema or acute respiratory distress syndrome (ARDS), which can be life-threatening and requires immediate intervention.

Choice D: Central venous pressure of 12 mm Hg

Reason: The normal range for central venous pressure (CVP) is 2-8 mm Hg. A CVP of 12 mm Hg is elevated, indicating possible fluid overload or heart failure. While this is concerning and requires monitoring, it is not as immediately critical as bilateral crackles, which directly affect oxygenation and respiratory function.

A. Obtain a urine specimen for culture and sensitivity. B. Instruct in effective techniques to cleanse the glans penis. C. Palpate the client's suprapubic area for distention. D. Advise the client to maintain a voiding diary for one week.

Correct Answer is C

Explanation

Choice A reason: While obtaining a urine specimen is important for diagnosing infection, it does not address the immediate discomfort and potential urinary retention the client may be experiencing.

Choice B reason: Cleansing the glans penis is part of good hygiene but does not address the client's symptoms of a full bladder and weak urine flow.

Choice C reason: Palpating for suprapubic distention can provide immediate information about bladder fullness and potential urinary retention, which may require prompt intervention.

Choice D reason: Maintaining a voiding diary is useful for tracking symptoms over time but does not provide an immediate assessment or intervention for the client's current symptoms.

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A nurse is caring for a client with binge eating disorder. Which goal should the nurse establish first with the client?

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Naxlex Comprehensive Predictor Exams

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